Individual
MISTY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1631 RITTER DR, DANIELS, WV 25832-9264
(304) 763-3051
Mailing address
115 CRANDALL CT, SHADY SPRING, WV 25918-8726
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-0421
WV
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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